• Alternative protocols in pediatric patients with newly isolated Bcc have been described with some success and have utilized similarly aggressive regimens combining inhaled and intravenous Tobramycin, Ceftazidime and Temocillin. (medscape.com)
  • The mechanisms by which this was achieved appeared to be through constitutive increase of intracellular c-di-GMP concentrations via mutations in the phosphodiesterase dipA, the yfiBNR signalling complex and bifunctional diguanylate cyclase/ phosphodiesterase morA, Next, whether biofilm and planktonic lineages took disparate evolutionary trajectories to resistance to the antipseudomonal antibiotics, ciprofloxacin, ceftazidime and tobramycin was investigated. (uea.ac.uk)
  • Isolates were tested against ciprofloxacin, ceftazidime, tobramycin, colomycin, tazocin and meropenem by disc diffusion method (total 9200 sensitivity patterns). (bmj.com)
  • Like all aminoglycosides, tobramycin does not pass the gastro-intestinal tract, so for systemic use it can only be given intravenously or by injection into a muscle. (wikipedia.org)
  • Like other aminoglycosides, a major side effect for tobramycin is ototoxicity or a loss of equilibrioception, or both in genetically susceptible individuals. (wikipedia.org)
  • Pharmacokinetics - Tobramycin, like the other aminoglycosides is not appreciably ab-sorbed after oral or intrauterine administration, but it is absorbed from topical administra-tion (not skin or urinary bladder) when used in irrigations during surgical procedures. (elephantcare.org)
  • citation needed] The effect of tobramycin can be inhibited by metabolites of the Krebs (TCA) cycle, such as glyoxylate. (wikipedia.org)
  • quinidine will increase the level or effect of tobramycin by P-glycoprotein (MDR1) efflux transporter. (medscape.com)
  • PK parameters of tobramycin were calculated before and after introduction of TIS, which was given 5-9 h after the IV dose. (nih.gov)
  • Achieving this is further complicated by a high degree of inter- and intra-patient variability in the PK parameters of tobramycin. (doseme-rx.com)
  • Methoxyflurane, when used as an inhalational anesthetic, can aggravate the nephrotoxic effects of injected tobramycin. (wikipedia.org)
  • Intravenous (IV) tobramycin, an aminoglycoside antibiotic, is a standard treatment for Pseudomonas infection in patients with cystic fibrosis (CF). However, drug exposure must be maintained within a narrow therapeutic range. (doseme-rx.com)
  • Data were collected from adult CF patients prescribed once-daily intravenous tobramycin at the Mater Health Service (MHS) Respiratory Unit, Brisbane, Australia. (doseme-rx.com)
  • amphotericin B deoxycholate and tobramycin both increase nephrotoxicity and/or ototoxicity. (medscape.com)
  • tobramycin and bacitracin both increase nephrotoxicity and/or ototoxicity. (medscape.com)
  • cidofovir and tobramycin both increase nephrotoxicity and/or ototoxicity. (medscape.com)
  • neomycin PO and tobramycin both increase nephrotoxicity and/or ototoxicity. (medscape.com)
  • If the dose is too high, there is an increased risk of adverse events, such as nephrotoxicity and ototoxicity.1,2 If the dose is too low, there is an increased risk of therapeutic failure, antibiotic resistance and poor patient outcomes.3,4 As a result, therapeutic drug monitoring (TDM) - measurement of drug concentrations in the blood at known times - of tobramycin is essential to enable appropriate dose individualization. (doseme-rx.com)
  • Other diuretics can also increase the risk for side effects because they raise tobramycin concentrations in the body fluids. (wikipedia.org)
  • Aerosolized tobramycin inhalation solution (TIS) may be absorbed and result in measurable serum concentrations. (nih.gov)
  • Trough tobramycin concentrations were significantly influenced in some CF patients (45%), suggesting that timing of the inhaled dose should be considered when interpreting PK measures of IV tobramycin dosing. (nih.gov)
  • Moreover this phage could be seen by electron microscopy when mobilized with several antibiotics commonly used in CF patients including, tobramycin, ciprofloxacin, cotrimoxazole, or imipenem. (biomedcentral.com)
  • Tobrex eye drops are a 0.3% tobramycin sterile ophthalmic solution produced by Alcon Pharmaceuticals. (wikipedia.org)
  • Tobramycin is contraindicated in people with hypersensitivity against aminoglycoside antibiotics. (wikipedia.org)
  • Pharmacology - Tobramycin, like the other aminoglycoside antibiotics, act on susceptible bacteria presumably by irreversibly binding to the 30S ribosomal subunit thereby inhibit-ing protein synthesis. (elephantcare.org)
  • Tobramycin is an aminoglycoside antibiotic derived from Streptomyces tenebrarius that is used to treat various types of bacterial infections, particularly Gram-negative infections. (wikipedia.org)
  • Chemistry - An aminoglycoside derived from Streptomyces tenebrarius , tobramycin oc-curs as a white to off-white, hygroscopic powder that is freely soluble in water and very slightly soluble in alcohol. (elephantcare.org)
  • The new method was validated through the analysis of a clinically relevant antibiotic resistance trait in Pseudomonas aeruginosa, an important bacterial pathogen. (uprsignaling.com)
  • One of the most intriguing and clinically relevant features of microbial biofilms is their significantly higher antibiotic resistance relative to their free-floating counterparts, which generates serious consequences for therapy of biofilm-associated infections. (medscape.com)
  • Perform culture and antimicrobial susceptibility testing when clinically indicated. (cdc.gov)
  • Over half of the selective agents were able to collaterally select for reduced susceptibility to antibiotics indicating that the widespread use of these agents may act as a driver of clinically-relevant drug resistance. (uea.ac.uk)
  • Vancomycin and tobramycin were used to prevent infection recurrence. (biocomposites.com)
  • This patient is now weight bearing as tolerated and clinically no signs of infection. (biocomposites.com)
  • Hospital-acquired pneumonia (HAP), or nosocomial pneumonia, is a lower respiratory infection that was not incubating at the time of hospital admission and that presents clinically 2 or more days after hospitalization. (medscape.com)
  • No standard reference range exists for a tobramycin level when administered as a single-daily dose. (medscape.com)
  • Peak levels are used to adjust the tobramycin dose per administration and should be within the reference range to be considered therapeutic. (medscape.com)
  • Dose individualization of tobramycin is usually performed by taking two blood samples at fixed time points (relative to dose administration) and interpolating these into an estimation formula. (doseme-rx.com)
  • As a result, therapeutic drug monitoring (TDM) of tobramycin is essential to enable appropriate dose individualization beyond covariate-based dosing (i.e. using age and/or mg/kg). (doseme-rx.com)
  • For these reasons parenteral tobramycin needs to be carefully dosed by body weight, and its serum concentration monitored. (wikipedia.org)
  • To test the effectiveness of the procedure for mutant identification, we screened for mutations reducing intrinsic resistance to the aminoglycoside antibiotic tobramycin. (uprsignaling.com)
  • Intrinsic tobramycin resistance had been previously analyzed at genome scale using mutant-by-mutant screening and thus provided a benchmark for evaluating the new method. (uprsignaling.com)
  • tobramycin resistance genes, the majority of which were then verified with individual mutants. (uprsignaling.com)
  • Combining tobramycin with betalactam antibiotics can be desirable because of their synergistic effects. (wikipedia.org)
  • Tobramycin is an aminoglycoside antibiotic that is used for treatment of infections of susceptible strains of aerobic gram-negative bacteria that are resistant to less-toxic antibiotics. (medscape.com)
  • Subsequent tobramycin doses are either increased or decreased to attain levels within this range. (medscape.com)
  • Measurable tobramycin levels due to inhalational therapy with conventional dosing in the reported patient indicate that the drug can be systemically absorbed, and renal tubular toxicity may occur. (cysticfibrosis.online)
  • Tobramycin is thus said to be a drug with a narrow therapeutic index. (wikipedia.org)
  • To be effective and well tolerated, tobramycin drug exposure must be maintained within a narrow therapeutic range. (doseme-rx.com)
  • Topical corticosteroid eye drops, such as 0.1% dexamethasone and 1% prednisolone acetate, are commonly applied for two to four weeks until the intraocular inflammation subsided clinically. (springer.com)
  • Uses/Indications - While there are no approved veterinary tobramycin products in the U.S., tobramycin may be useful clinically to treat serious gram negative infections in most species. (elephantcare.org)
  • Tobramycin works by binding to a site on the bacterial 30S and 50S ribosome, preventing formation of the 70S complex. (wikipedia.org)
  • Since inadequate dialysis increases mortality and morbidity of patients, therefore, assessment of dialysis adequacy is clinically important. (iranpath.org)
  • Data from a 2013 trial, illustrated above, demonstrates an improvement in lung function, compared with tobramycin, in three cycles of the drug. (dkbmed.com)
  • tobramycin decreases effects of microbiota oral by pharmacodynamic antagonism. (medscape.com)
  • The distinguishing phenotypic characteristics of the five major clinically relevant species are given in Table 1 . (antimicrobe.org)
  • Fourteen patients had a reduced calculated elimination rate constant after TIS administration, which may be misinterpreted as a decreased clearance of IV tobramycin. (nih.gov)
  • [ 13 , 16 ] Although it is not clear which patients are most likely to benefit from Bcc eradication, early eradication is likely to be clinically significant given the general association between Bcc colonization and progressive clinical decline. (medscape.com)
  • An additional case-series described combination of inhaled amiloride and tobramycin with eradication of initial colonization in 3 of 4 patients but was unsuccessful in chronically infected patients. (medscape.com)
  • Tobramycin, in its injectable form, is also indicated for various severe or life-threatening infections caused by susceptible strains: sepsis, meningitis, lower respiratory tract infections, intra-abdominal infections, skin infections, bone infections, and skin structure infections, complicated and recurrent urinary tract infections. (wikipedia.org)
  • citation needed] Muscle relaxants and diethylether can add to the neuromuscular blocking effects of tobramycin. (wikipedia.org)
  • tobramycin increases effects of atracurium by pharmacodynamic synergism. (medscape.com)
  • tobramycin decreases effects of BCG vaccine live by pharmacodynamic antagonism. (medscape.com)
  • tobramycin increases effects of cisatracurium by pharmacodynamic synergism. (medscape.com)
  • tobramycin increases effects of rapacuronium by pharmacodynamic synergism. (medscape.com)
  • Tobramycin administered using an extended interval is monitored and adjusted using a 24-hour AUC, a nomogram, or based on an end of interval level. (medscape.com)
  • The following drugs or solutions are reportedly incompatible or only compatible in spe-cific situations with tobramycin: cefamandole naftate, furosemide and heparin sodium. (elephantcare.org)
  • These metabolites protect against tobramycin lethality by diverting carbon flux away from the TCA cycle, collapsing cellular respiration, and thereby inhibiting Tobramycin uptake and thus lethality. (wikipedia.org)
  • Data from one of the original trials on inhaled tobramycin showed dramatic improvement in lung function with a 28-day on/off cycle for inhaled tobramycin. (dkbmed.com)
  • Alternating aztreonam and tobramycin preserves lung function that would be lost during the off periods of an on/off cycle. (dkbmed.com)
  • Of these, three were categorized as A. Twenty products that are not marketed in Sweden, of which six due to extensive use in Europe, were evaluated clinically. (folkhalsomyndigheten.se)